On the Global Day of Action for Access to Safe Abortion: the Egyptian government should sign the Maputo Protocol and take action to protect the life and health of women

The Egyptian Initiative for Personal Rights and the feminist global alliance Realizing Sexual and Reproductive Justice (RESURJ) call on the Egyptian government to amend the abortion law and to ratify the protocol on the rights of women in Africa. The Maputo Protocol of the African Charter on Human and Peoples’ Rights guarantees safe medical abortions for women whose lives or health are endangered by the continuation of the pregnancy, and where the pregnancy is a result of rape or incest (Article 14, Paragraph 2C).1

EIPR and RESURJ note that Egypt has not signed the protocol, adopted by the African Union General Assembly in 2003. Apart from Egypt, the only other members of the African Union that have neither signed nor ratified the protocol are Tunisia and Botswana.

The two thus renew their call for the Egyptian parliament to amend the law in order to guarantee women’s access to safe abortion in cases where pregnancy constitutes a threat to the woman’s life or health, or if the pregnancy is the result of rape or incest.

Egyptian law pertaining to abortion is among the most restrictive worldwide, as it criminalizes abortion and stipulates imprisonment for women who intentionally abort.2 This is despite repeated attempts by civil society organizations, as well as activists and former MPs, to amend the law. Several human rights bodies have issued clear recommendations urging the government to amend legislation to allow access to abortion for women whose life or health is threatened or whose pregnancy is the result of rape or incest, and to annul all punitive measures against women seeking abortions.3 However, the Egyptian government persists in violating women’s rights and harming their health and well-being.

The current legal framework also discriminates against women in multiple ways. EIPR and RESURJ assert that amending the Egyptian Penal Code on abortion is in essence a matter of social equality.

While women who have the money — and access to information — can often access relatively safe abortion despite its criminalization, this is not true of their poorer counterparts especially girls living on the street, domestic workers, refugees and those with disabilities. These women, many of them the survivors of rape, are unable to access safe abortions in the appropriate time and often resort to desperate and life-threatening measures, such as inserting a sharp object into the vagina or ingesting traditional concoctions.

That the physicians’ Code of Ethics permits doctors to conduct an abortion in cases where the life or health of the woman are endangered is insufficient. It leaves women with no guarantee of access to safe abortions, and at the mercy of doctors, pharmacists and hospitals who often refuse to provide them with assistance, or may ask for a religious opinion (fatwa) allowing the abortion before the physician performs it. Some doctors request money or sexual favors in exchange for performing an abortion.

We publish the stories of women and their experiences of unsafe abortions or being unable to access abortions at all. These testimonies shed light on the hardships that women face are not reducible simply to their being women, but are linked to the multiple levels of discrimination and marginalization that they face.

Summary of the Maputo Protocol:

The Maputo Protocol consists of 32 articles and is considered one of the most progressive documents on women’s rights. Its provisions span personal, economic, civic and political rights, including health and reproduction, harmful traditional practices, non-discrimination, education and the right to participation. The comprehensive document also takes account of other rights such as the right to peace and the right to a positive cultural environment.

1 Article 14 – Health and reproductive rights

1. States Parties shall ensure that the right to health of women, including sexual and reproductive health is respected and promoted. This includes:

a) the right to control their fertility;

b) the right to decide whether to have children, the number of children and the spacing of children;

c) the right to choose any method of contraception;

d) the right to self protection and to be protected against sexually transmitted infections, including HIV/AIDS;

e) the right to be informed on one’s health status and on the health status of one’s partner, particularly if affected with sexually transmitted infections, including HIV/AIDS, in accordance with internationally recognized standards and best practices;

b) establish and strengthen existing pre-natal, delivery and post-natal health and nutritional services for women during pregnancy and while they are breast-feeding;

c) protect the reproductive rights of women by authorizing medical abortion in cases of sexual assault, rape, incest, and where the continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the fetus.

2 Egyptian criminal code articles pertaining to abortion:

Article 261: Anyone who intentionally induces a miscarriage in a pregnant woman by giving her medication or by using means leading to such or by directing her to them, with or without her consent, shall be subject to imprisonment.

Article 262: A woman who willingly and knowingly takes medication or willingly uses the aforementioned means, or enables another party to use such means, thereby inducing a miscarriage shall be subject to the aforementioned penalty.

Article 263: If the person inducing the miscarriage is a doctor, surgeon, pharmacist, or midwife, he shall be subject to a defined term of hard labor.

Article 264: There shall be no penalty for attempted induced miscarriage.

Testimoies of women and their experiences of unsafe abortions or being unable to access abortions at all:

I was 15 when I was raped and I found out I was pregnant from the workers in one of the NGOs that I go to. The girls with me on the street advised me to drink boiled coca cola. The whole thing only cost me the price of a bottle of coke, and I had bleeding afterwards. Of course I felt that there was a danger to my health and I knew that I could go to jail, but what could I do?

A woman came to the hospital, she was 29-years-old and visibly very weak. She told us that she was married and that her husband worked as a court stenographer. She said that she had three children, was pregnant but that her health was frail and could not withstand another pregnancy. She was anemic and emaciated and in the very early phases of the pregnancy. The doctor was at first sympathetic and gave her a sonogram. She found two amniotic sacs — of course the fetuses could not be seen yet because it was the very first few weeks — then she told the woman that she was pregnant with twins, that she couldn’t help her, and that God would certainly help her and grant her the necessary means to care for them. The woman looked desperate and asked for the name of a drug to induce a miscarriage. The doctor refused to tell her, advising her to come back in a week for another sonogram. The woman left and never came back.

We see dozens of refugees pregnant as a result of rape. Of course if we were talking about refugees who have been raped we would say hundreds, but pregnancy resulting from rape is in the dozens. Any assistance that we offer in terms of helping them to abort is unofficial because the law does not allow abortion and so we fear for our work and for the doctors who work with us.

One of the sad things is that most of the cases of pregnancy resulting from rape among refugees are of girls aged around 16 or 17, and as a result of shock, stigma or ignorance they speak out late about what has happened to them, often more than four months into the pregnancy. Or sometimes we realize a young woman is pregnant only when she starts to show. By then of course abortion is impossible and all we can offer is to test for STDs.

Whenever these rape survivors are forced to continue the pregnancy, the results are catastrophic. Some adamantly refuse to keep the baby, and we have to look for a care home which is very difficult. Even in cases where the mothers keep the baby, it turns into a nightmare because the authorities refuse to register the baby without a father, and when the baby remains with no documents this can end up with a refusal to renew the residency of the woman because they worry that she may have kidnapped the baby. Actually, it has become quite the norm that most refugee families have one or two kids resulting from rape..this should not be the case.

I was 13 when I became pregnant. I found out very late because I was young and didn’t know what pregnancy meant. I told the father to register the baby in his name but he refused. My friends told me to get abortion pills from the pharmacy. So I begged for the money for the pills and went and got them. I took them and had heavy bleeding afterwards. I went to a government hospital where they stopped the bleeding but treated me very badly. I didn’t know then that what I had done was illegal.I think that when the father doesn’t acknowledge the baby and the mother lives on the street like me, then she should have the right to an abortion.

I still can’t remember how that old sick man was able to find me. He came to meet me in 2012 holding under his arm a folder stuffed with documents. He pulled out a picture of a young woman and told me it was his daughter.

The young woman, 20 years old, has a mental disability, her mother passed away and he was trying to take care of her as best as he could. He was married to another woman who, I gather, was mistreating her. The young woman would leave the house and disappear for days. The neighborhood knew her well and would help him bring her back. One time she returned with her clothes torn and her face cut and bleeding. It was obvious that she had been sexually assaulted. Her father took her to the police station. He insisted the police officer file a report of the incident who was in turn being uncooperative. The prosecution investigated and the woman recognized three of the men arrested, but the prosecutor invalidated her testimony because of her mental disability and the report was dismissed.

The father sent telegrams to the Interior Ministry, the Security Directorate, the Ministry of Social Solidarity, the Prosecutor General, the Cabinet and the president’s office. He was resolute. A general at the Interior Ministry sympathized with him and the prosecution investigated the incident again. It was found that among the suspects were informants working with the area’s police station, and the investigations were dismissed again.

By this time, four months had passed and the young woman started to show signs of pregnancy, because of course no one had given her a pregnancy test, emergency contraception or tested for STDs after she was raped. The father took her to a doctor to get an abortion but the doctor refused, and no one agreed to perform an abortion on her.

Some neighbors suggested to the man that he admit her to one of the centers known for supporting similar cases, which he did and there she delivered a baby girl. Every time he would visit her he would notice scratches on her neck and tears in her clothes. His daughter told him that one of the workers in the center hit her and had sexually harassed her more than once.

The father filed a complaint to the administration and they said they would investigate.

The last time he went to see her, he found that his daughter had been referred to Abbassiya psychiatric hospital and the baby admitted to an orphanage. They refused to tell him which orphanage, despite his telling them that he would register the baby in his name. I tried to help him. I taped an interview with him, and photocopied all the documents he had. I wrote to friends and acquaintances who work in rights organizations but didn’t receive an answer for months.

I think that a woman who gets raped has the right to decide whether she wants to live with the result of this rape for the rest of her life or not.